United States • State law varies • No national US living will
This is general legal information, not legal advice.

Living Will & Advance Directive Basics (US)

What a living will covers • how it differs from a health care POA • DNR and POLST • state formalities • when a clinician may refuse
Specialty: this page separates the four documents people confuse — the living will, the health care power of attorney, the DNR order and a medical order such as a POLST — and gives you the list of questions your own state’s statute answers.
Federal regulation defines an “advance directive” as a written instruction — such as a living will or durable power of attorney for health care — recognised under State law and relating to your care when you are incapacitated (42 CFR § 489.100). That single definition tells you two things: the living will and the health care power of attorney are two limbs of the same family, and the family is defined by your state, not by Washington.
Jurisdiction warning — read this first
This page covers the United States only, and we do not name any individual state’s rule. A US living will has no legal effect in England & Wales, Scotland, Northern Ireland, Ireland, Australia or Canada, which use their own instruments. Scotland and Northern Ireland differ from England & Wales too, so there is no single “UK” counterpart to link to as if it were one thing.
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Wording your wishes
State questions
Best for people saying:
  • “Is a living will the same as a will?”
  • “I don’t want to be kept on a machine.”
  • “Do I need one document or two?”
  • “What’s the difference between this and a DNR?”
  • “Does the hospital have to follow it?”
  • “I made one years ago — is it still good?”
Start with one paragraph. We’ll ask only what’s needed.

How this guide helps

Three steps — name the document, write the wishes, make it findable.
1) Work out which document you actually mean
“Living will”, “advance directive”, “health care proxy”, “DNR” and “POLST” are four different things that people use interchangeably. Getting this right is most of the work.
2) Say something a clinician can act on
“No heroic measures” is not an instruction. This page shows the structure a modern form uses: a treatment block, a separate food-and-liquids block, and defined situations they apply in.
3) Put it where it will be found
The clinician’s duty to record your instruction is triggered by being told about it. An unfindable directive is functionally no directive.

What a living will is — and the two things it is not

One job: it records what care you do and do not want, for a time when you cannot say so.
A living will explains the care you do or do not want. MedlinePlus, the US National Library of Medicine’s patient-education encyclopedia (review date 14 January 2026), describes it as covering wishes about CPR if your breathing or heartbeat stops, feeding through a tube into a vein or the stomach, extended care on a breathing machine, tests, medicines and surgeries, and blood transfusions.
Two things it is not. MedlinePlus states plainly that a living will does not deal with financial issues and is not the same as a last will and testament, and that you cannot name someone to make health care decisions for you in a living will. One speaks while you are alive but cannot speak; the other speaks after you have died. Naming a decision-maker is a different document.
In statutory language the “living will” is usually not called that. On the modern uniform pattern — the Uniform Law Commission’s Uniform Health-Care Decisions Act (2023), a model act that is law only where a legislature has enacted it — an “advance health-care directive” means a power of attorney for health care, a health-care instruction, or both. What people call a living will is the health-care instruction limb: a direction indicating your goals, preferences or wishes about care being provided, withheld or withdrawn, including one intended to take effect if a specified condition arises.

The four documents people mix up

Most confusion on this topic is really a naming problem.
Living will (health-care instruction)
Written by you, about treatment. Names no decision-maker. Speaks when you cannot.
Health care power of attorney
Written by you, about a person. Lets a named health care agent or proxy decide for you. MedlinePlus notes it gives no power over legal or financial decisions.
DNR order
Written by a clinician on your medical chart, telling providers not to attempt CPR if your breathing or heartbeat stops. Discussed with you, your proxy or your family first.
A medical order such as a POLST
A medical order recording treatment preferences. The Uniform Law Commission gives it as the worked example of a later instruction that can override an earlier directive — see below. We do not state who may sign one, or whether such a programme exists where you live — ask your own clinician.
Most people need the first two, and one document can usually carry both. On the uniform pattern an instruction may sit in the same record as a power of attorney for health care, and a power of attorney for health care may include an instruction. Whether your state expects one combined form or two separate ones is a state question.
The most recent instruction wins — including a medical order. Under the model act, a later instruction that conflicts with an earlier one, including an instruction documented in a medical order, revokes the earlier one to the extent of the conflict. The official comment works it through: where a medical order — “including a POLST, sometimes referred to as a Physician Order for Life Sustaining Treatment” — records a preference inconsistent with an earlier advance directive, the medical order governs; and a later instruction by you would in turn govern over the medical order. We cannot tell you whether such a programme exists where you live, or what it is called there — ask your own clinician.

What actually goes in it

The structure below follows the Uniform Law Commission’s own optional form. Use it as a skeleton, not as your state’s statutory form.
  • Naming an agent — the power-of-attorney limb, if you are combining the two.
  • Instructions about life-sustaining treatment, split deliberately into a treatment block and a separate food and liquids block. Each offers a choice between care always being given, or not being provided in defined situations.
  • The defined situations the model form uses: a condition that is not curable and is expected to cause death soon even if treated; being unconscious and not expected to regain consciousness; and a condition from which recovery is not expected that prevents you communicating with the people you care about, caring for yourself and recognising family and friends. There is a free-text “other” option too — use it.
  • Optional special powers and guidance — preferences about which professionals or institutions treat you, how a decision should be made and communicated, who should and should not be consulted, and who you would want appointed as guardian if one is ever appointed.
  • Organ donation — a heading in the model form. We do not state any donation rule, registry or mechanism on this page; ask about it where you live.
  • Signatures — yours, and a witness.
  • Information for agents — the plain-English page your agent will actually read at 3am.
One nuance worth knowing: naming someone as your preferred guardian in an instruction is not consent to a guardianship. The Commission’s comment says such a nomination gives no indication that you want a guardian appointed and should never be read as consent to one, though a court will likely select your nominee absent cause to appoint someone else.

Writing it and signing it — where state law bites

This is the section where a generic template is most likely to let you down.
The 2023 model act takes a permissive line on instructions: its comment says creating one “does not require compliance with any particular set of formalities”, reflecting that people express wishes in writing, orally and otherwise. Do not generalise that. Many state living-will statutes do impose writing and witness requirements, and the model is law only where enacted. MedlinePlus’s practical advice is the right advice everywhere: write it according to your state’s laws, and put wishes in writing rather than relying on verbal instructions, which may supplement a written directive but invite confusion on their own.
The moment your document also appoints an agent, formalities bite properly. On the model pattern a power of attorney for health care must be in a record, signed by you, and signed by one adult witness who reasonably believes you are acting voluntarily and knowingly and who is not the agent, the agent’s spouse, domestic partner or cohabitant, or — where you live in or are cared for at a nursing home or other residential care facility — that facility’s owner, operator, employee or contractor. That model requires no notarisation, and treats a witness as present over real-time audio-and-video, or audio only where the witness knows you or can authenticate your identity.
Confirm all of this for your own state before you sign. Witness count, notary requirement, who may witness, whether there is a mandatory statutory form or wording, how “terminal condition” and “permanently unconscious” are defined, whether artificial nutrition and hydration can be refused at all, minimum age, and any pregnancy provisions are all state-law questions. We name no state’s rule here.
Making one costs you no rights. Under the model act your right to make your own health care decisions while you have capacity is unaffected by whether you have created or revoked a directive, and capacity is presumed. Capacity is also decision-specific: it turns on being willing and able to communicate a decision — independently or with services, technology, supported decision making or other reasonable accommodation — and, for an instruction, understanding the nature and consequences including the primary risks and benefits of the choices you are expressing.

Does a doctor have to follow it?

There is a duty to comply, a short list of exits, and a duty attached to using an exit.
On the 2023 model, a health care professional or institution shall comply with your health care instruction, with a surrogate’s reasonable interpretation of it, and with a surrogate’s decision, to the same extent as if you had made the decision yourself with capacity. The exits are defined and narrow: the instruction is contrary to an institutional policy expressly based on reasons of conscience that was timely communicated; the care is not available to that professional or institution; or complying would be contrary to the professional’s religious belief or moral conviction where other law permits refusal on that ground, contrary to generally accepted health-care standards, or would violate a court order or other law.
Using an exit is not the end of it. The model requires the professional or institution to tell you, if possible, and the surrogate as soon as reasonably feasible; to immediately make a reasonable effort to transfer you to a professional or institution willing to comply; and, meanwhile, to keep providing life-sustaining care and comfort care consistent with accepted medical standards until the transfer. (The model sets a minimum period in one limb as a bracketed placeholder for each legislature to fill in, so we state no number of days.)
The federal layer runs in parallel. 42 CFR § 489.102(c) says a provider is not required to give care that conflicts with an advance directive, and is not required to implement one where as a matter of conscience it cannot and State law allows conscientious objection — and the provider must state any such limitation clearly and precisely in its written policy, identifying the state legal authority and the range of conditions or procedures affected. Complaints about non-compliance go to the State survey and certification agency.
And interfering with a directive is actionable. The model act prohibits intentionally falsifying a directive; concealing, defacing, obliterating or deleting one or a revocation without consent in order to frustrate your intent; withholding knowledge of its existence or revocation from the responsible professional or institution; coercing or fraudulently inducing someone to create or revoke one; and requiring or prohibiting a directive as a condition of providing health care. Some states give you or your estate a right to sue. We state no figure, because the model leaves the amount to each legislature.

Keeping it working: copies, revoking, moving state, mental health

The commonest failure is not a drafting error. It is a filing cabinet.
  • Tell people, then hand over copies. On the model act a health care professional to whom you communicate or give an instruction must document it and its date in your medical record, and a responsible professional told that a directive has been created or revoked must record that as soon as reasonably feasible and request a copy for the record. MedlinePlus’s practical list: give copies to family, providers and your health care agent; carry a copy; take one if you go into hospital; and tell all medical staff about it.
  • Copies are as good as the original. Under the model, a physical or electronic copy of a directive or a revocation has the same effect as the original, and a certified physical copy of an electronic directive can be made by affirming under penalty of perjury that it is complete and accurate.
  • Revoking is deliberately easy. You may revoke an instruction in whole or in part by any act clearly indicating the intention, including an oral statement to a health care professional, and a later conflicting directive revokes the earlier one to that extent. MedlinePlus adds the practical half: if you change your decisions you must tell everyone and re-share the new document.
  • Do not assume it travels. The model’s portability rule treats a directive made elsewhere as valid if it complies with the law of the state named in it, the state where it was made, or the act — and says a person may assume it is genuine, valid and in force unless there is good cause to think otherwise. But portability is itself a state-law question and that rule only helps in a state that enacted it. Being in electronic form cannot, by itself, defeat legal effect or admissibility on the model.
  • Mental health is a separate category. The model allows a directive addressing only mental health care, containing an instruction, a power of attorney for health care, or both — covering your general philosophy and objectives, preferences about professionals, programmes and facilities, admission to a mental health facility including duration, medications, and refusal of specific types of mental health care. That is the gap most generic living-will templates leave wide open.
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FAQ — living wills and advance directives (US)

Tap to expand. Written for US readers in plain English. State law varies throughout.
1) Is a living will the same as a last will and testament?
No. MedlinePlus states that a living will does not deal with financial issues and is not the same as a last will and testament. A living will speaks while you are alive but unable to communicate; a last will speaks after death.
2) Can I name someone to decide for me in my living will?
Not in the living will itself — MedlinePlus says so directly. Naming a health care agent or proxy is done in a health care power of attorney. Most people want both, and on the modern uniform pattern one document can carry both.
3) Is “advance directive” the same as “living will”?
Advance directive is the wider family. Federal regulation defines it as a written instruction — such as a living will or a durable power of attorney for health care — recognised under State law. The living will is one member of that family.
4) Does a living will give me a DNR?
No. A do-not-resuscitate order is written by a clinician on your medical chart after discussion with you, your proxy or your family. Your living will can record your wishes about CPR, but the order itself is a clinical document.
5) Can a POLST or similar medical order override my living will?
On the uniform pattern, a later instruction — including one documented in a medical order — revokes an earlier one to the extent of the conflict, and the Commission’s worked example is exactly a POLST. A later instruction from you would in turn govern over the order. Whether such a programme exists near you is a question for your clinician.
6) Does it have to be written down, witnessed or notarised?
Write it down — always. Beyond that it is a state-law question and we will not guess it. The 2023 model act imposes no particular formalities on an instruction, but many state living-will statutes do. Confirm your state’s requirements before signing.
7) What situations should my instructions cover?
The model form uses three: a condition not curable and expected to cause death soon even if treated; being unconscious and not expected to regain consciousness; and a condition from which recovery is not expected that prevents you communicating, caring for yourself and recognising family and friends. It also leaves a free-text option — use it.
8) Why is “food and liquids” a separate box on the form?
Because artificial nutrition and hydration are treated as their own decision. The model form separates a treatment block from a food-and-liquids block, and whether they can be refused at all is one of the most state-variable parts of this area. Answer both boxes deliberately.
9) Can I change my mind?
Yes, and deliberately easily. On the model, revocation may be by any act clearly indicating the intention, including an oral statement to a health care professional. Practically: revoke in writing, tell everyone, hand out the new version and collect the old copies back.
10) Does making one weaken my right to decide now?
No. On the model act your right to make your own health care decisions while you have capacity is unaffected by whether you have created or revoked a directive, and capacity is presumed.
11) Will it be honoured if I move or travel between states?
Do not assume so. The uniform portability rule honours directives made elsewhere, but only in a state that enacted it. If you move, winter elsewhere or are treated across a state line, have it reviewed there.
12) Does it cover mental health treatment and admission?
Usually only if you drafted for it. The model act treats mental health care as its own category, covering preferences about professionals, programmes and facilities, admission including duration, medications, and refusal of specific types of care. Generic templates commonly leave this blank.
13) Does my US living will work in the UK, Ireland, Australia or Canada?
No. It has no legal effect there. Those jurisdictions use their own instruments — and they differ from each other, so there is no single “UK” document. See our England & Wales page if that is where you need cover.
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This is general legal information, not legal advice. For advice on your own situation, speak to a lawyer licensed in your state.